Mutism: What can I do if my child won’t speak?

What is mutism?

Mutism is a rare communication disorder that can affect children, adolescents and adults. People with mutism are organically able to speak and also master the language. However, because of a strong fear or social phobia, they remain silent.

Causes and forms of mutism

Mutism usually occurs in connection with a social phobia. Affected people are very afraid of being the center of attention and possibly acting embarrassingly. But withdrawal or resistance can also be related to the disease. Mutism occurs in various forms, each of which also has different possible causes:

• Selective mutism: This form occurs mainly in children from kindergarten age and adolescents, and more often in girls than boys. The selective form is difficult for parents to recognize, because at home in the family or with close friends, the affected child speaks quite normally or even above average. Only in other environments, such as kindergarten or school, and with strangers does it remain silent. In addition to the causes described above, there can also be a genetic predisposition. Inhibitions, stubborn behavior or depression can often be observed in the family environment of those affected. But increased attention or a central position in the family can also play a role.
• Total mutism: This form is the most severe form and is easier to recognize because the affected person no longer speaks at all. Triggers are usually shock experiences. The total form of the communication disorder often occurs together with depression, psychosis and other psychiatric illnesses. It almost never occurs in children.
• Akinetic mutism: This is a serious neurological disorder that must be distinguished from selective and total mutism. The affected person is awake and does not show any paralysis. However, she does not speak, does not move and does not show any emotion, because she lacks any drive to do so. Causes can be, for example, brain damage as a result of a stroke, craniocerebral trauma, tumors or hydrocephalus.

treatment of mutism

In selective and total mutism , a so-called multifactorial therapy is often useful. This is a mixture of speech, psychotherapy, family therapy and psychiatry. In adolescents and adults, medication in the form of antidepressants can also be administered. Systemic Mutism Therapy (SYMUT), for example, was designed specifically for patients with communication disorders, combining speech and behavioral therapy measures. The use of homeopathic remedies can also be crowned with success.

In the case of akinetic mutism , the original disease, for example the stroke, is decisive for the further development. An improvement can also be seen months later.

Signs of selective mutism in your child

Since it is difficult for you as a mother to recognize selective mutism in your child, it makes sense to ask the kindergarten teachers or teachers about their communicative behavior from time to time.

In addition, the following points can indicate that your child suffers from the communication disorder. If you observe one or more of these abnormalities, it is advisable to speak to your pediatrician or a child psychologist:

• Your child is silent towards certain people or in special situations.
• Your child no longer speaks when strangers appear.
• Your child is afraid of physical activities such as riding a bike or climbing.
• Your child is afraid of being the center of attention.
• Your child worries about how it affects others.
• Your child is afraid to sleep alone
• Occasional bedwetting

Shy or mutic?

Even shy children do not necessarily like to talk to strangers or in unfamiliar situations. However, unlike children with mutism, they will respond when spoken to or, after a while, will begin to speak on their own when they feel a little more confident.

Early treatment for mutism

If your child is diagnosed with mutism, there is a good chance they will overcome the disorder if treated early. Under no circumstances should you wait with therapy, because the side effects, such as being an outsider, problems at school, poor career prospects and depression, can be very serious and later plunge your child into a serious life crisis, which in the worst case can even lead to suicidal thoughts. However, if mutism is recognized and treated in good time, good therapeutic results can usually be achieved.